Thompson David S, Oberteuffer Robert, Dorman Todd
The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Comput Inform Nurs. 2003 Jan-Feb;21(1):22-6; quiz 27-8. doi: 10.1097/00024665-200301000-00009.
Screening patients for clinical studies is time-consuming for researchers. Inefficiencies from human-based eligibility screening cause delay in scientific breakthroughs and are costly. We sought to determine the reliability of an automated computer-based real-time eligibility screening tool. A time-motion diary study was conducted in two university-based intensive care units using a cohort-controlled design. Time saved by automated eligibility screening and the positive and negative predictive values of the integrated eligibility screening system were compared with the gold standard of manual chart review. Sepsis Alert and Diagnostic System sensitivity and specificity were 82% and 95%, respectively. Positive and negative predictive values were 87.5% and 93%, respectively. During evaluation, Sepsis Alert and Diagnostic System saved a minimum of 137 minutes for the study coordinator. Sepsis Alert and Diagnostic System serves as a reliable tool for real-time eligibility screening in an intensive care unit setting. Time efficiencies through use of Sepsis Alert and Diagnostic System may translate into cost savings for funding agencies. The concept and methodology deployed in this study are applicable to any facility with electronic medical record capacity, as long as the data within that system are granular enough to support the specific query.
对研究人员来说,为临床研究筛选患者非常耗时。基于人工的资格筛选效率低下,会导致科学突破延迟且成本高昂。我们试图确定一种基于计算机的自动化实时资格筛选工具的可靠性。采用队列对照设计,在两所大学附属医院的重症监护病房进行了一项时间-动作日记研究。将自动化资格筛选节省的时间以及综合资格筛选系统的阳性和阴性预测值与人工病历审查的金标准进行比较。脓毒症警报与诊断系统的灵敏度和特异度分别为82%和95%。阳性和阴性预测值分别为87.5%和93%。在评估过程中,脓毒症警报与诊断系统为研究协调员至少节省了137分钟。脓毒症警报与诊断系统是重症监护病房环境中实时资格筛选的可靠工具。使用脓毒症警报与诊断系统提高的时间效率可能会为资助机构节省成本。本研究中采用的概念和方法适用于任何具备电子病历能力的机构,只要该系统中的数据足够详细以支持特定查询。